Medical radioisotopes: governments and industry must change practices to ensure security of supply

The OECD/NEA Steering Committee for Nuclear Energy calls on governments and industry to work together to implement fundamental changes in the molybdenum-99 supply chain to ensure long-term reliability of supply. Molybdenum-99 (⁹⁹Mo) and its decay product, technetium-99m (^99mTc), the most widely used medical radioisotope, are used in medical diagnostic imaging techniques that enable precise and accurate, early detection and management of diseases such as heart conditions and cancer, all in a non-invasive manner. Disruptions in the global supply chain of these medical isotopes over the past two years have had significant impacts on patients, who have had important diagnostic tests cancelled or delayed.

On 28 April, the OECD/NEA Steering Committee for Nuclear Energy formally endorsed a policy approach to restructure those aspects of the market that are currently functioning unsustainably, and to promote an internationally consistent approach to ensure the long-term, secure supply of medical radioisotopes. Although the supply situation has stabilised for the moment, it remains fragile and the Committee stresses that the underlying problem threatening security of supply – an unsustainable economic structure – remains to be adequately addressed.

The policy approach recognises the need for structural reform and recommends clear actions to governments for establishing an economically sustainable supply chain. In particular, it calls on:

• producers to implement full-cost recovery for ⁹⁹Mo activities as a way to ensure continued investment in the industry;
• actors and stakeholders in the supply chain to source, value and pay for reserve capacity sufficient to cope with the unexpected loss of key production sources;
• governments to continue to fulfil their essential role in establishing the proper environment for safe and efficient market operations;
• governments to support the conversion to use of low enriched uranium targets for ⁹⁹Mo production, wherever technically and economically feasible;
• governments and essential supply chain participants to collaborate internationally to ensure a globally consistent approach to addressing security of supply of ⁹⁹Mo/^99mTc;
• supply chain participants to support a periodic review of progress on implementing an economically sustainable supply chain.

The NEA High-level Group on the Security of Supply of Medical Radioisotopes (HLG-MR), established in 2009, developed the principles of this policy approach which should be applied by countries that have an impact on the global market, either as ⁹⁹Mo/^99mTc producers or consumers. The implementation of these principles, for which the HLG-MR is developing supporting recommendations, is essential to achieving change and security of supply. Unless actions are taken to ensure long-term security of supply, the OECD/NEA Steering Committee for Nuclear Energy warns that supply shortages could become commonplace over the next decade.

The Statement by the OECD/NEA Steering Committee for Nuclear Energy Regarding Policy Actions Necessary to Ensure the Long-term Security of Supply of Medical Radioisotopes, including the full set of principles, can be found on the NEA website at www.oecd-nea.org/med-radio/statement.html.

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